This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. P01-CA67165 Program Project, Program Director Ferenc A. Jolesz MD IMAGE-GUIDED THERAPY Project Start: 30-SEP-1995 Project End: 30-APR-2012 Program Summary The long-term objective of the application under consideration, a competing renewal of our Program Project in MR-guided Therapy, is to provide the scientific, medical, and technical infrastructure for the development of interventional and intraoperative MRI for the treatment of brain and prostate cancer. This Program Project combines several technological advances related to the use of high field MRI with an advanced imaging platform. In parallel, this proposal addresses issues related to limited access to the patient in the closed bore magnet. The goal is to move most of the procedures (open surgeries, thermal ablations) to the advanced 3Tesla imaging platform to achieve a faster and more flexible image acquisition which, in turn, will provide improved localization, targeting, monitoring and therapy control for those procedures that can be adapted to this new application environment. To this end, we will undertake the following research initiatives: Project 1: Develop computational methods that account for anatomical changes during neurosurgical intervention and optimize the frequency of serial imaging; Project 2: Build an image-guided and controlled therapy delivery system for the non-invasive destruction of prostate cancer with MRI-controlled focused ultrasound; Project 3: Provide image-control for manipulators and robotic devices that enhances the manual capacity of physicians and facilitates procedures in a closed bore magnet; Project 4: Develop novel imaging platforms and methods for enhanced parallel MRI data acquisition applicable to image-guidance;and Project 5: Create an integrated image-based system to allow MR-guided targeted interventions for the treatment of prostate cancer. These five projects will work synergistically to not only develop better imaging methods for defining the cancers, but will also work to facilitate the improved, targeted treatment of brain tumors and prostate cancer. This proposal combines several technological advances related to the use of high field MRI for the image guided treatment of brain and prostate cancer. The goal is to move most of the procedures (open surgeries, thermal ablations) to the advanced high field MRI imaging platform to achieve a faster and more flexible image acquisition which, in turn, will provide improved localization, targeting, monitoring and therapy control for those procedures that can be adapted to this new clinical application environment. Projects Overview Project 1 - Integrated Intraoperative Guidance for Neurosurgery - Alexandra J Golby MD &Neculai Archip PhD Project 2 - MR Guided Focused Ultrasound - Nathan J McDannold PhD &Gregory Clement PhD Project 3 - Image-Based Navigation for Interventional Robotic Devices [unreadable]Nobuhiko Hata PhD Project 4 - Enhanced Parallel MRI Data Acquisition - Gary P Zientara PhD &Lawrence P Panych PhD Project 5 - MRI Guided Interventions in the Prostate - Clare M Tempany MD Benefits to the NCIGT The main objective of the P01 Project 1 is to build a system to improve intraoperative visualization, navigation and monitoring for image-guided neurosurgery. This Project will serve as a testbed for the basic image-guided Neurosurgery technology that is developed in the U41 Image-Guide Brain Tumor Surgery Core. An objective of the P01 Project 1 is specifically to create an augmented reality visualization of the intraoperative configuration of the patient's brain merged with high resolution preoperative imaging data, including honing the science to improve intraoperative navigation, targeting and visualization, again implementation issues. This Project and Project 3 necessarily will make direct use of the techniques and facilites developed under the U41 Computational Core. Project 3 has the main objective to develop accurate and robust methods for tracking the motion of interventional devices during MRI-guided procedures, an effort complementing the aims of the U41. The main objective of the P01 Project 4 is implementation-focused research for the AMIGO suite, to translate the latest 3D dynamic imaging technical advances - specifically published techniques in Parallel MRI and reduced field-of-view methods - into practical functions on the 3T 16-channel MRI scanner that will be part of our AMIGO suite. This Project is highly complementary to the U41 Imaging Core's goal of producing Parallel MRI libraries, and will become a testbed for the products of the U41 Imaging Core. The main objective of the P01 Project 2 is to both use intracavitary ultrasound phased arrays to effectively coagulate prostate tumors, and use through-the-skull FUS technology to ablate brain tumors. This Project again will serve as a testbed for the technology developed in the U41 Focused Ultrasound Core, which is devoted to designing and building phased array systems for FUS. The main objective of the P01 Project 5 is focused on the implementation aspects of the prostate IGT application, to adapt, for a 3T scanner, and use MR-guided prostate brachytherapy and biopsy computer software originally developed for the 0.5T scanner. This Project will benefit the U41 MRT Core since it will provide a special application case supporting the aim of the U41 MRT Core, which is to design and perform completely new IGT procedures for MR-guided neuro-surgery, MR-guided prostate interventions and MR-guided thermal ablations. Benefits to the Project The main objective of the U41 Image-Guide Brain Tumor Surgery Core is to develop the infrastructure required to translate basic technological advances from other parts of the effort to the clinical treatment of patients with brain tumors (includes: high-resolution functional MRI (fMRI), diffusion tensor imaging (DTI), and intraoperative electrophysiologic testing (ECS)). This has a tremendous benefit to P01 Project 1 since this Core is focused on developing the basic technology to enable the Neurosurgical procedures aimed to be accomplished in the P01 Project 1. The main objective of the U41 Computational Core is to develop general technology to ensure accuracy in determining coordinate systems, coordinate transformations, and device coordinates used in MRT/Slicer projects, develop general user interface software, computer systems specialized as MR scanner adjuncts for IGT, and HPC versions of state-of-the-art 3D image processing software. This Core will mainly provide the basic computer and AMIGO table-side technology for P01 Project 3, which will implement robotics applications for IGT. Also, The U41 Computational Core will provide programming and up-to-date software design expertise to the P01 Project 4. The main objective of the U41 Imaging Core project is to develop novel fast and efficient imaging methods, such as non-Fourier RF encoding, line-scan imaging and parallel imaging, and make them available as a resource for enhancing the full range of MRI-guided therapy applications. A major product of the U41 Imaging Core is the DARTS realtime data acquisition system, which will become an integral part of the fast imaging implementation aimed for in the P01 Project 4. Again, the U41 research provides the basic technology to enable the implementation and application research in the P01. The main objective of the Focused Ultrasound Core proposal is to take an advantage of two dimensional ultrasound phased arrays for image guided thermal ablation, including designing ultrasound phased array applicators that will provide electronic beam steering, constructing the ultrasound phased array applicators to test the design, and testing to verify the design and construction. This research will provide the key ingredients for the FUS application-oriented Project 2 of the P01.